[Impact noise and hearing. A study from audiometry screening in noisy occupational environments]

The hearing loss of 46,776 subjects exposed to hazardous impact or continuous noise was measured: 11% were exposed to impact noise (10.3% in men, 12.7% in women). Impact noise causes less hearing loss than continuous noise up to a noise emission level (NIL) of 115 dB(A). This result is still compatible with the concept of equivalent continuous A-weighted sound pressure level (LA,eq) and seems to be caused by the protective effect of the stapedius muscle. However, at emission levels higher than 115 dB(A), not covered by ISO 1999 prognosis, impact noise becomes more detrimental. This could be the effect of mechanical damage to the organ of Corti, as observed in animal experiments at sound pressure levels exceeding 114 dB(A). A diminishing protective function of the stapedius muscle could explain the more serious hearing impairment after long exposure to impact noise compared with shorter exposures to an equal dose. Since the hearing loss caused by impact or continuous noise is clearly different in the highest NIL ranges, safety criteria for impact noise should be revised. The NIL defined by Burns and Robinson underestimates the effect of the exposure time for impact noise.